Weigert Monika, Krischker Ursula, Pöhl Michaela, Poschalko Gunda, Kindermann Christoph, Feichtinger Wilfried
Institut für Sterilitätsbetreuung, Vienna, Austria
Fertil Steril. 2002 Jul;78(1):34-9. doi: 10.1016/s0015-0282(02)03174-6.
To compare IVF-ET outcome with a new stimulation protocol using clomiphene citrate (CC) with recombinant FSH and LH to stimulation with the standard long GnRH-a protocol.
Prospective randomized study.
Outpatient infertility clinic in Vienna, Austria.
PATIENT(S): Two hundred ninety-four infertile women undergoing IVF-ET; 154 IVF cycles stimulated with CC + recombinant FSH + recombinant LH (group A) and 140 cycles with long GnRH-a suppression + recombinant FSH (group B).
INTERVENTION(S): Controlled ovarian hyperstimulation, egg retrieval, and ET.
MAIN OUTCOME MEASURE(S): Cycle parameters (number of oocytes, fertilization, number of embryos) and outcome (pregnancy rate, cancellation rate, ovarian hyperstimulation syndrome [OHSS]).
RESULT(S): Pregnancy rate per ET was 42.9% (implantation rate, 21.3%) in group A and 36.6% (17.4%) in group B. Cancellation rates were similar. The OHSS occurred in four cases (3%) in group A and 12 cases (10%) in group B.
CONCLUSION(S): Stimulation with CC + recombinant FSH + recombinant LH leads to comparable pregnancy rates vs. the long protocol. With this new stimulation, less gonadotropins are used and there is less need for monitoring (lower cost for patient and clinic). The risk of OHSS is reduced as well. Therefore, this protocol should be regarded as the first-line treatment.
比较使用枸橼酸氯米芬（CC）联合重组促卵泡生成素（FSH）和促黄体生成素（LH）的新刺激方案与标准长方案促性腺激素释放激素激动剂（GnRH-a）刺激方案进行体外受精-胚胎移植（IVF-ET）的结局。
前瞻性随机研究。
奥地利维也纳的门诊不孕症诊所。
294名接受IVF-ET的不孕女性；154个IVF周期采用CC+重组FSH+重组LH刺激（A组），140个周期采用长方案GnRH-a抑制+重组FSH刺激（B组）。
控制性卵巢过度刺激、取卵和胚胎移植。
周期参数（卵母细胞数量、受精情况、胚胎数量）和结局（妊娠率、取消率、卵巢过度刺激综合征[OHSS]）。
A组每次胚胎移植的妊娠率为42.9%（着床率为21.3%），B组为36.6%（17.4%）。取消率相似。A组有4例（3%）发生OHSS，B组有12例（10%）发生OHSS。
CC+重组FSH+重组LH刺激方案与长方案相比，妊娠率相当。采用这种新的刺激方案，促性腺激素用量减少，监测需求降低（患者和诊所成本降低）。OHSS风险也降低了。因此，该方案应被视为一线治疗方案。
